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The accuracy of endometrial Pipelle sampling with and without sonographic measurement of endometrial thickness
R Goldchmit1, Z Katz, I Blickstein
1Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Objective:
To evaluate the accuracy of Pipelle endometrial sampling with and without sonographic measurement of endometrial thickness.
Methods:
We studied prospectively 176 consecutive patients (23% after and 77% before menopause) scheduled for D&C. Sonographic measurement of the endometrium and endometrial biopsy with the Pipelle were performed before the curettage.
Results:
In 159 cases (90%), the endometrial histologic results of curettage agreed with those of the Pipelle biopsy. All three cases of endometrial cancer were identified by Pipelle aspiration. In seven cases (4%), the Pipelle aspiration failed to detect hyperplasia. Sonographic endometrial thickness of more than 5 mm slightly increased the sensitivity and slightly decreased the specificity of Pipelle aspiration from 82 to 92% and from 99 to 96%, respectively. In postmenopausal patients admitted for bleeding, the sensitivity and specificity reached 100%.
Conclusions:
Our data suggest that normal Pipelle aspirates in premenopausal patients with abnormal uterine bleeding are highly accurate. In postmenopausal patients with sonographic endometrial thickness of 5 mm or less, the accuracy reached 100%.